Juvenile Justice Mental Health Diversion Guidelines and Principles

Implementation of the National Judicial Task Force to Examine State Courts' Response to Mental Illness Report and Recommendations

The Task Force made a number of important findings, with corresponding recommendations, supported by over 100 new resources for courts and our partner stakeholders. Going forward each Behavioral Health Alerts will revisit an original Task Force resource or a new resource that supports a Task Force recommendation.

Juvenile Justice Mental Health Diversion Guidelines and Principles Well over half of youth who come in contact with the juvenile justice system have a mental health disorder.4 These mental health issues are far more prevalent among youth involved with the juvenile justice system than in youth in the general population, and present unique challenges for juvenile justice practitioners, schools, communities, and other relevant systems. The juvenile court holds an integral role in developing, implementing, and supporting mental health diversion through both judicial leadership and the expertise of juvenile justice professionals such as Directors of Court Services, Court Administrators, and Chief Probation Officers. The following Guidelines are supported by the National Judicial Task Force to Examine State Courts’ Response to Mental Illness and outline critical components of effectively diverting youth with mental health needs from juvenile justice involvement.

Task Force Recommendations Implementation - Resources and News

Miami’s Model for Defendants With Severe Mental Illness The nation’s jails house an estimated 1.7 million people with severe mental illnesses. The incidence of serious mental illness in jails is four to six times higher than in the population at large. As WFAE and Frontline has been reporting in our series, “Fractured,” locking up defendants with serious mental illness can make their mental health worse. It’s expensive, and it’s often not very effective at reducing crime. If former inmates don’t get treatment when they’re released, they’re likely to get arrested again. But in Miami, public officials have been managing defendants with mental illness very differently. The program is the brainchild of Miami-Dade Judge Steve Leifman, although he wouldn’t call it that. He’d say he’s just applying what’s been shown to work. A lot of places are paying attention, including North Carolina. Last year, teams from 22 states traveled to Miami-Dade to hear about the programs.

Pilot for mental health and substance use diversion program picks up steam Chief Justice Kate Fox illustrated the need to rethink how the state’s judicial and criminal justice systems approach mental health and to reinforce the significance of the diversion pilot project that the state will begin in Gillette next year. Though the diversion program aims to curb backlogs in the courts, jails and at the Wyoming State Hospital, and reduce the tremendous cost and inefficiency of incarcerating low level offenders, the program’s ultimate goal is to better serve those who have mental health concerns, Rep. Lloyd Larsen, R-Lander, the co-chair of the task force, said during the May meeting. “Yes, it will reduce impacts on courts. Yes, it will reduce congestion at state hospitals and in jails,” he said. “But more importantly rather than punishing people through the court system we’re trying to get them the help they need.”

Brooklyn Mental Health Court addressing mental illness in criminal justice system Inside Brooklyn Mental Health Court, presiding judge, Hon. Matthew D'Emic, sits among decorations, a warm touch that he says helps contribute to establishing a relationship with each participant, which is paramount. "If you do that, then, like any relationship, you don't want to disappoint each other," said Judge D'Emic. "We have frequent court appearances, and I know that my clinical team stays in touch with the programs really on a daily basis," said D'Emic. "And I can bring the defendant into court, advance the case to the following day and talk to them." In 2022, there were 167 referrals. Out of those, 100 became participants and 82 graduated.


Research and Resources

Reducing Frequent Jail Contact to Lower Jail Populations This new research found people with frequent bookings accounted for about one-half of all the bookings that occurred during the study period. Across eight sites, people with frequent jail contact account for a majority of bookings, but a minority of people booked. People of Color and people with behavioral health needs were overrepresented. The study’s findings also emphasize complex interrelationships between race and ethnicity, gender, and behavioral health needs. They point to potential disconnects between the perceived and actual characteristics of people with frequent jail contact.

Making Changes Work in the Criminal Justice System: Best Practices for Quality Improvement Implementing changes in the criminal justice system can seem daunting and arduous. With recent legal requirements and continuing best practice updates, making changes is more important than ever. This webinar will present practical tools and approaches for implementing changes strategically and thoughtfully. August 1 @2:00

Ask the Expert: Crisis Response in Rural Areas Small and rural jurisdictions often face distinct challenges that make it difficult to implement crisis response programs. Join us for an ask-the-expert webinar session focused on the unique experiences of people working on crisis response in rural areas and listen to our panelists as they provide a brief overview of the work they’re doing in Arizona to respond to people experiencing a behavioral health crisis.

Apply Now to Join a Community of Practice on Police-Mental Health Collaboration Staff Wellness With support from the U.S. Department of Justice’s Office of Justice Programs’ Bureau of Justice Assistance, The Council of State Governments Justice Center is hosting a virtual Community of Practice (CoP) to aid agencies in learning how to preserve and strengthen the mental and physical wellbeing of their police-mental health collaboration (PMHC) staff. Participants of the CoP should work for a law enforcement agency, mental health agency, or community organization that is either currently part of a PMHC or planning to start one.

A Practitioner's Guide to Constitutional and Legal Issues in Adult Drug Courts All Rise is thrilled to announce a new, groundbreaking publication, "A Practitioner's Guide to Constitutional and Legal Issues in Adult Drug Courts." Produced in partnership with the Center for Justice Innovation, this guide is intended to help practitioners identify and navigate the major legal issues that arise in adult drug courts. Throughout the guide, its authors offer practice recommendations in areas where the law is unsettled or especially complex. These recommendations are the authors’ best advice for complying with the law while also operating an effective program that adheres to evidence-based practices.

2023 COSSUP National Forum On August 29–31, 2023, join Comprehensive Opioid, Stimulant, and Substance Use Program (COSSUP) grantees, select Bureau of Justice Assistance (BJA) grantees, federal partners, and invited guests from across the country in the fight against America’s opioid, stimulant, and other substance use crisis. Plenary and break-out sessions will highlight:

  • Maximizing resources through multidisciplinary partnerships, including law enforcement/first responder collaborations.
  • Post-arrest interventions for individuals with substance use disorders including pre-trial diversion, jail-based medication-assisted treatment, and continuum of care services upon reentry.
  • The unique value and role of peer recovery support services across the sequential intercept model.

Departments of Labor, Health and Human Services, Treasury announce proposed rules to strengthen Mental Health Parity and Addiction Equity Act The proposed rules seek to fully protect the rights of people seeking mental health and substance use disorder benefits and provide clear guidance to plans and issuers on how to comply with the law’s requirements. In developing their proposals, the departments drew from their combined and individual experiences in enforcing the act and in working with plans and issuers, as well as state regulators.

The various faces of vulnerability: offering neurointerventions to criminal offenders In recent years, we have witnessed considerable progress in neurotechnologies that visualize or alter a person’s brain and mental features. In the near future, some of these technologies could possibly be used to change neural parameters of high-risk behavior in criminal offenders, often referred to as neurointerventions. The idea of delivering neurointerventions to criminal justice populations has raised fundamental normative concerns, but some authors have argued that offering neurointerventions to convicted offenders could be permissible. One prominent worry that is often emphasized in the literature, relates to the vulnerability of convicted offenders in prison and forensic patients in mental health facilities. In this paper, we aim to show that as far as vulnerability is considered relevant within the context of offering medical interventions to offenders, it could contribute to arguments against as well as in favor of these offers.

Reinventing the E.R. for America's Mental Health Crisis It’s hard to imagine a less therapeutic environment for a person in crisis than an emergency department: crowded and windowless rooms; harsh fluorescent lights; the ceaseless ping of alarms; this patient retching, that one screaming. And yet, for every eight patients who present at an emergency department, one is there for a behavioral crisis such as psychosis, suicidality, mania, aggression, or substance use. In May, I travelled to a suburb of Minneapolis in search of a different approach to mental-health crises. We walked down a long hallway to the area where Mitlyng now treats psychiatric emergencies, as a clinical supervisor. On the other side of a door was a spacious, mellow room that reminded me of an airport’s business-class lounge. The mental-health unit where Mitlyng works is one of only a few dozen Empath units, short for Emergency Psychiatry Assessment, Treatment, and Healing.

TAC Research Weekly: Mental health workforce shortages in Oregon A qualitative study, published last month in “Psychiatric Services,” asked mental health and substance use treatment providers, administrators, and policy experts in Oregon about the factors contributing to turnover and attrition in the public mental health treatment system. Researchers found five key themes that contributed to the public mental health workforce crisis in Oregon: Low wages, documentation burden, poor administrative and physical infrastructure, lack of career development opportunities, and a chronically traumatic work environment.

Judges and Psychiatrists Leadership Initiative Newsletter How States Are Using Certified Community Behavioral Health Clinics to Address Mental Health and Substance Use Needs in the Justice System, a report on promoting community-based treatment at the All Rise conference, and more.

A crisis of neglect: How society can help those with mental illness We live in one of the most prosperous countries in human history. Surely, we can help the most vulnerable in our society.


In the News

To reduce mental health stigmas, judge talks openly about his anxiety Judges have the fourth-most stressful job in the country, according to a ranking by the The Occupational Information Network. There’s a reason for that, and it’s got a lot to do with a relatively unknown aspect of the job: the secondary (or bystander) trauma trial court judges experience daily. Therapists and physicians I’ve spoken to say this is one of the major hazards of the job. If you’re wondering why I have spoken to therapists and physicians about judges and stress, well it’s because I experience bystander trauma firsthand. I’ve also been diagnosed with an anxiety disorder that multiplies the stress of being a judge.

Extensive staffing crisis at L.A. County courts puts vulnerable defendants in dire straits Public defenders who work in Hollywood’s decrepit mental health courthouse say they’re juggling at least 500 cases each, a situation so out of control that their boss allegedly proposed a radical solution earlier this year: stop declaring doubts about the ability of their mentally ill clients to stand trial.

Oklahoma is trying to treat people with severe mental illness in jail, but many still languish in cells waiting for hospital beds When the Oklahoma Department of Mental Health and Substance Abuse Services launched the program to treat criminal defendants with severe mental illness in county jails in December 2022, more than 200 people were on a waitlist for a bed at the Oklahoma Forensic Center — some waited a year or more. Weeks earlier, the U.S. Department of Justice announced it had launched an investigation into Oklahoma’s mental health system. “They started this jail restoration thing solely so they could say ‘we don’t have a waitlist’ because they were getting a lot of heat for having people that were a number 120-something and number 130-something on a waitlist for a bed,” Howard said. “They don’t have adequate beds to do the treatment that’s needed. But the way around that isn’t to just not do the treatment.”

Promoting Access to Treatment and Housing (PATH) Act Introduced The PATH Act will improve access to mental health and substance use disorder services among unhoused individuals by establishing a new office within the Substance Abuse and Mental Health Services Administration (SAMHSA) to lead federal efforts to improve and expand access to substance use disorder (SUD) and mental health services for individuals experiencing housing instability and homelessness, and by establishing a grant program funded at $2 billion for each fiscal year over a period of five years that will provide funds for States, cities, territories, and Tribes to improve behavioral health, mental health, and substance use disorder services, as well as comprehensive housing services, in consultation with the HUD Continuum of Care program.

Biden-⁠Harris Administration Takes Action to Promote Access to Behavioral Health Care for Asian American, Native Hawaiian, and Pacific Islander Communities Last week, the Biden-Harris Administration hosted its inaugural mental health summit focused on improving equity and access to behavioral health care for Asian American, Native Hawaiian, and Pacific Islander (AA and NHPI) communities. The White House Initiative on Asian Americans, Native Hawaiians, and Pacific Islanders (WHIAANHPI) and the U.S. Department of Health and Human Services (HHS) hosted this historic event in recognition of National Minority Mental Health Awareness Month, building on the Administration’s unprecedented investments to connect more Americans to care.


Wellbeing

Wellness works: Why employee wellbeing should be a business imperative The last three years have been tumultuous, to say the least, and led to a huge shift away from traditional business models and toward a new world of work. The ways in which we share, communicate, live and connect were turned upside down as a result of the pandemic, on top of increased instability felt around the globe – and it all took a massive toll on employees’ mental health. A recent report from Manulife Financial shows 71 per cent of Canadian workers said “their mental health has interfered with their ability to work in the past year.”

Creating a Mentally Healthy Workplace Now more than ever, creating a mentally healthy workplace is a business imperative. Access to interactive and dynamic mental health training is in high demand. The WHO estimates that depression and anxiety cost the economy $1 trillion annually in lost productivity. Implementing this leader training not only benefits the bottom line but also communicates the organization's commitment to employee mental health and well-being.

New APA Poll Pinpoints the Extent of Toxicity in the Workplace Of the 2,515 employed adults polled in the U.S., 19 percent believe their workplace is very or somewhat toxic. Likewise, an even higher percentage, 22 percent, said they have experienced harm to their mental health at work. The vast majority of respondents to the APA’s survey—92 percent—said it is very or somewhat important their employers value emotional and psychological well-being. Likewise, 92 percent also believe it is very or somewhat important for their employers to support employee mental health.

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